Computed tomography derived fractional flow reserve testing in stable patients with typical angina pectoris: influence on downstream rate of invasive coronary angiography.
Computed tomography derived fractional flow reserve testing in stable patients with typical angina pectoris: influence on downstream rate of invasive coronary angiography.
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DOI：
10.1093/ehjci/jex068
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发表时间：
2018-04-01
期刊：
影响因子：
--
通讯作者：
Nørgaard BL
中科院分区：
文献类型：
--
作者：
Jensen JM;Bøtker HE;Mathiassen ON;Grove EL;Øvrehus KA;Pedersen KB;Terkelsen CJ;Christiansen EH;Maeng M;Leipsic J;Kaltoft A;Jakobsen L;Sørensen JT;Thim T;Kristensen SD;Krusell LR;Nørgaard BL
在典型心绞痛稳定患者中评估下游冠状动脉造影（伊卡）的使用和一线冠状动脉CT血管造影（CTA）联合选择性CT衍生血流储备分数（FFRCT）检测的短期安全性。2016年1月1日至2016年6月30日期间，所有因疑似CAD而转诊至奥胡斯大学医院接受非急诊伊卡或冠状动脉CTA的患者（N = 774）均进行了一线CTA。记录3个月内的下游检测和治疗以及≥90天的不良事件。根据是否存在典型心绞痛，将患者分为两组，根据当地实践，这将导致转诊至伊卡（低-中等风险，n = 593 [76%];高风险，n = 181 [24%]），CAD的平均试验前概率分别为31 ± 16%和67 ± 16%。745例（96%）患者进行了冠状动脉CTA，其中212例（28%）患者接受了FFRCT处方。在高风险组和低中风险组中，取消伊卡的比例分别为75%和91%。高风险患者行冠状动脉血运重建的频率高于中低风险患者，分别为76%和52%（P = 0.03）。平均随访时间为157 ± 50天。4例患者发生了严重临床事件，但通过冠状动脉CTA和选择性FFRCT检测取消伊卡的任何患者均未发生严重临床事件。在真实世界实践中，典型心绞痛稳定患者的一线冠状动脉CTA和选择性FFRCT检测与计划ICA的高安全取消率相关。
To assess the use of downstream coronary angiography (ICA) and short-term safety of frontline coronary CT angiography (CTA) with selective CT-derived fractional flow reserve (FFRCT) testing in stable patients with typical angina pectoris. Between 1 January 2016 and 30 June 2016 all patients (N = 774) referred to non-emergent ICA or coronary CTA at Aarhus University Hospital on a suspicion of CAD had frontline CTA performed. Downstream testing and treatment within 3 months and adverse events ≥90 days were registered. Patients were divided into two groups according to the presence of typical angina pectoris, which according to local practice would have resulted in referral to ICA, (low-intermediate-risk, n = 593 [76%]; high-risk, n = 181 [24%]) with mean pre-test probability of CAD of 31 ± 16% and 67 ± 16%, respectively. Coronary CTA was performed in 745 (96%) patients in whom FFRCT was prescribed in 212 (28%) patients. In the high- vs. low-intermediate-risk group, ICA was cancelled in 75% vs. 91%. Coronary revascularization was performed more frequently in high-risk than in low-intermediate-risk patients, 76% vs. 52% (P = 0.03). Mean follow-up time was 157 ± 50 days. Serious clinical events occurred in four patients, but not in any patients with cancelled ICA by coronary CTA with selective FFRCT testing. Frontline coronary CTA with selective FFRCT testing in stable patients with typical angina pectoris in real-world practice is associated with a high rate of safe cancellation of planned ICAs.
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影响因子：
24
作者：
Norgaard, Bjarne L.;Leipsic, Jonathon;Achenbach, Stephan
通讯作者：
Achenbach, Stephan
影响因子：
168.9
作者：
Newby, David;Williams, Michelle;Steedman, Tracey
通讯作者：
Steedman, Tracey
影响因子：
39.3
作者：
Douglas PS;Pontone G;Hlatky MA;Patel MR;Norgaard BL;Byrne RA;Curzen N;Purcell I;Gutberlet M;Rioufol G;Hink U;Schuchlenz HW;Feuchtner G;Gilard M;Andreini D;Jensen JM;Hadamitzky M;Chiswell K;Cyr D;Wilk A;Wang F;Rogers C;De Bruyne B;PLATFORM Investigators
通讯作者：
PLATFORM Investigators
影响因子：
24
作者：
Meijboom, W. Bob;van Mieghem, Carlos A. G.;de Feyter, Pim J.
通讯作者：
de Feyter, Pim J.
影响因子：
6.2
作者：
Packard, Rene R. Sevag;Li, Dong;Karlsberg, Ronald P.
通讯作者：
Karlsberg, Ronald P.